Pancreatology最新文献

{"title":"Feasibility of sham vs. pancreatic endotherapy for painful chronic pancreatitis: Lessons from a randomized trial","authors":"Gregory A. Coté , B. Joseph Elmunzer , Anh Phan , Haley Nitchie , Czarinna M. Posadas , Robert Moran , Erin Forster , Kaveh Sharzehi , Jessica Yu , Patty Hutto , April Williams , Jeffrey Borckhardt , Valerie Durkalski-Mauldin","doi":"10.1016/j.pan.2026.01.007","DOIUrl":"10.1016/j.pan.2026.01.007","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 482-485"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterisation of early-onset pancreatic adenocarcinoma molecular profile compared to average-onset pancreatic adenocarcinoma (CARAPAC): A systematic review and a meta-analysis","authors":"Mathias Brugel ,&nbsp;Vivien Riviere ,&nbsp;Audrey Hubert ,&nbsp;Léonie Langanay ,&nbsp;Olivier Bouche ,&nbsp;Michaël Genin ,&nbsp;Victoria Gauthier ,&nbsp;Jean-Baptiste Oudart","doi":"10.1016/j.pan.2026.03.002","DOIUrl":"10.1016/j.pan.2026.03.002","url":null,"abstract":"<div><h3>Background</h3><div>Early-onset pancreatic adenocarcinoma (EOPA), defined as the diagnosis of pancreatic adenocarcinoma before the age of 50, is increasingly reported and may differ molecularly from average-onset pancreatic adenocarcinoma (AOPA). Understanding these differences is essential for precision medicine in this poor-prognosis malignancy.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted following PRISMA guidelines. Studies published between 2015 and 2025 reporting molecular data on EOPA and/or AOPA were identified. Comparative studies stratified by age group for molecular alterations were included in the meta-analysis. Quality assessment was performed using the JBI checklist. This study aimed at systematically review and meta-analyse existing data comparing the molecular landscape of EOPA and AOPA, and evaluate whether EOPA constitutes a distinct molecular subgroup of pancreatic adenocarcinoma.</div></div><div><h3>Results</h3><div>Thirty-nine articles were included in the systematic review, of which eight met criteria for meta-analysis. <em>KRAS</em> mutations were significantly less frequent in EOPA than in AOPA (OR = 0.61; 95%CI [0.43–0.86], p = 0.005). No significant differences were observed for <em>TP53, CDKN2A, SMAD4</em>, or <em>BRCA1/2</em> alterations. Sensitivity analyses confirmed the robustness of the <em>KRAS</em> finding. Study heterogeneity was moderate (I² = 40%). Quality assessment revealed substantial variability in design, molecular methods, and reporting standards.</div></div><div><h3>Conclusions</h3><div>EOPA is enriched in <em>KRAS</em> wild-type tumours. This profile may offer alternative therapeutic opportunities, including RNA-based fusion detection, inclusion in targeted therapy trials, and suggest alternative oncogenic pathways for a proportion of this subpopulation. Standardised definitions, consistent molecular reporting, and exploration of age-specific risk factors are critical to improve understanding and management of EOPA.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 421-427"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissolving the problem: Biodegradable stents as a value-driven strategy for post-ERCP pancreatitis prophylaxis in high-risk patients","authors":"Clement Wu ,&nbsp;Venkata Akshintala","doi":"10.1016/j.pan.2026.04.002","DOIUrl":"10.1016/j.pan.2026.04.002","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 337-339"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcriptomic profiling of insulinomas reveals a new “low-endocrine” subtype with low YY1 expressions","authors":"Yongzheng Li ,&nbsp;Xingwu Zhang ,&nbsp;Qiang Xu ,&nbsp;Xianlin Han ,&nbsp;Dan Guo ,&nbsp;Yixi Jiao ,&nbsp;Hao Zhang ,&nbsp;Bohui Yin ,&nbsp;Xiafei Hong ,&nbsp;Wenming Wu","doi":"10.1016/j.pan.2026.02.006","DOIUrl":"10.1016/j.pan.2026.02.006","url":null,"abstract":"<div><h3>Background</h3><div>Insulinoma is the most common functional pancreatic neuroendocrine tumors, typically originating from pancreatic β cells. However, the transcriptional heterogeneity and the regulatory role of transcription factor <em>YY1</em> remain incompletely understood.</div></div><div><h3>Methods</h3><div>High-throughput bulk-RNA sequencing was conducted on insulinoma tumor samples. Unsupervised clustering algorithms were employed to identify molecular subtypes of insulinomas. <em>YY1</em> mutation status was analyzed by whole-exome sequencing. Functional roles of <em>YY1</em> were analyzed by <em>Yy1</em>-overexpression and knockdown in INS-1 cell line. Spatial transcriptomic characteristics of insulinoma were analyzed using Visium HD platform.</div></div><div><h3>Results</h3><div>Transcriptomic analysis identified two distinct expression patterns: a low-endocrine subtype and an endocrine subtype. The low-endocrine subtype was characterized by reduced <em>PDX1</em> and insulin synthesis pathways, with an enrichment in exocrine-related functions. However, these two subtypes exhibited similar clinicopathological features. Notably, while <em>YY1</em> mutation rates were comparable between the two subtypes, <em>YY1</em> expression levels were significantly reduced in the low-endocrine subtype. Functional experiments demonstrated that <em>Yy1</em> levels directly correlated with insulin production, as <em>Yy1</em> overexpression in INS-1 cells markedly upregulated insulin processing genes and secretory pathways. <em>Yy1</em> knockdown led to suppression of insulin. Furthermore, spatial transcriptomics confirmed that low-endocrine subtype possessed reduced insulin scores compared to the endocrine subtype.</div></div><div><h3>Conclusion</h3><div>We found a low-endocrine subtype insulinoma with reduced <em>YY1</em> expression and insulin synthesis transcriptomic signature. This highlights the transcriptomic heterogeneity of insulinomas.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 451-458"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147309115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activation of pancreatic acinar cells by very low concentrations of cholecystokinin: mechanism and implications for physiology and pathology","authors":"Muhanad Salih,&nbsp;Ole H. Petersen","doi":"10.1016/j.pan.2026.03.006","DOIUrl":"10.1016/j.pan.2026.03.006","url":null,"abstract":"<div><div>Cholecystokinin (CCK) is one of the three classical gut hormones. CCK is also, in contrast to the other two principal gut hormones (gastrin and secretin), an important neurotransmitter with widespread actions in the brain and in the periphery. Although not signposted by its name, one of the key physiological actions of CCK is to activate the secretion of an enzyme-rich neutral fluid produced by the pancreatic acinar cells. In general, hormones activate their target cells at concentrations that are much lower than those of neurotransmitters but, even in this context, the pancreatic acinar cells are extraordinarily sensitive to extremely low CCK concentrations (low pM). We explore the mechanism underlying this exceptional sensitivity as well as its consequences. The focus is on the intracellular transduction pathways that are activated when acinar cell CCK receptors are excited by the hormone. Uniquely, three different intracellular receptors – all linked to release of Ca²⁺ from intracellular stores – are required for CCK to elicit secretion. The implications of this unusual arrangement for both pancreatic physiology and pathophysiology are discussed.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 343-354"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aggressive fluid resuscitation in predicted severe acute pancreatitis: a secondary analysis of a multicenter randomized controlled trial","authors":"Yingjie Chen ,&nbsp;Weibang Pan ,&nbsp;Mingfeng Huang ,&nbsp;Hongwei Zhang ,&nbsp;Mingzhi Chen ,&nbsp;Zeqiu Lao ,&nbsp;Lin Gao ,&nbsp;Bo Ye ,&nbsp;Lu Ke ,&nbsp;Xiujuan Zhou ,&nbsp;Wenjian Mao ,&nbsp;Peiyang Gao","doi":"10.1016/j.pan.2026.03.009","DOIUrl":"10.1016/j.pan.2026.03.009","url":null,"abstract":"<div><h3>Background</h3><div>A recent trial showed that early aggressive fluid resuscitation in acute pancreatitis(AP) was associated with increased fluid overload characterized by respiratory symptoms/signs. However, the generalizability of these results in more severe AP is unknown. We aimed to evaluate the association between early fluid strategies and the incidence and duration of respiratory failure in patients with predicted severe acute pancreatitis(pSAP).</div></div><div><h3>Methods</h3><div>This is a secondary analysis using data from a multicenter, cluster-randomized trial of pSAP. The entire cohort was divided into three groups according to the amount of fluid volume. According to the interquartile range(IQR) value of fluid volume over the first two trial days, patients were assigned to conservative(quartile-1), moderate(quartile-2&amp;3), and aggressive(quartile-4) fluid strategies, respectively. A multivariable quantile regression model was used to demonstrate their effect on respiratory-failure-free-days(RFFD) to trial-day7.</div></div><div><h3>Results</h3><div>Overall, 259 pSAP patients were included, and the median(IQR) volume of fluid intake was 7.09(5.59–9.34) L. From lowest to highest, the three groups received median(range) fluid intake of 4.60(1.96–5.59), 7.09(5.59–9.34), and 11.22(9.34–18.78) L, respectively. The median(IQR) of RFFDs to trial-day7 were 5(2.3-7), 5(2-7), and 6(4-7) for each group. After adjustment for potential confounders, neither the conservative nor aggressive-group showed significant difference in RFFD compared with the moderate-group(p = 0.305 and 0.554, respectively). Moreover, the aggressive group had a higher SIRS free-days to trial-day7 compared with the moderate-group(adjusted p = 0.029). Subgroup analysis revealed that early aggressive fluid intake was not associated with decreased RFFDs to trial-day7 in all subgroups.</div></div><div><h3>Conclusion</h3><div>A higher amount of balanced fluids given according to the hematocrit and other clinical parameters does not appear to contribute to respiratory dysfunction in patients with pSAP.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 380-386"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early direct admission to tertiary hospital specialized care reduces risk of severe acute pancreatitis: A propensity score-matched retrospective cohort study","authors":"Yuping Ren ,&nbsp;Liang Xia ,&nbsp;Lingyu Luo ,&nbsp;Huifang Xiong ,&nbsp;Zhijian Liu ,&nbsp;Xin Huang ,&nbsp;Yupeng Lei ,&nbsp;Yin Zhu ,&nbsp;Nonghua Lu ,&nbsp;Jianhua Wan ,&nbsp;Wenhua He","doi":"10.1016/j.pan.2026.02.002","DOIUrl":"10.1016/j.pan.2026.02.002","url":null,"abstract":"<div><h3>Background</h3><div>The impact of delay in specialized treatment (DST) on disease progression in acute pancreatitis (AP) patients before transfer to tertiary hospitals remains unclear. This study investigates the association between DST and risk of severe acute pancreatitis (SAP) using propensity score matching (PSM).</div></div><div><h3>Methods</h3><div>Based on 5818 AP patients treated at The First Affiliated Hospital of Nanchang University (2014–2023), patients were divided into DST and non-DST groups. A 1:1 PSM with 0.2 SD caliper width balanced 16 baseline covariates. Multivariable logistic regression evaluated DST's effect on SAP, supported by inverse probability weighting and subgroup analyses.</div></div><div><h3>Results</h3><div>After PSM (2215 pairs), the DST group exhibited higher SAP incidence (19.5% vs. 14.9%; aOR = 1.38, 95%CI 1.18–1.62), pancreatic necrosis (18.1% vs. 15.4%), persistent respiratory failure (16.3% vs. 12.4%), and longer median hospitalization (8 vs. 7 days; all p &lt; 0.05). Subgroup analyses revealed amplified risks in BMI≥24 (OR = 1.44) and alcohol users (OR = 1.62). Sensitivity analyses confirmed robustness (weighted OR 1.14–1.52), while mortality showed no intergroup difference.</div></div><div><h3>Conclusions</h3><div>DST independently increases SAP risk. Early direct admission to tertiary specialized care reduces SAP risk by 38%, providing high-level evidence for optimizing AP management pathways, particularly prioritizing rapid referral for obese and alcohol-using populations.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 363-369"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for pancreatic exocrine insufficiency after acute pancreatitis: A systematic review and meta-analysis","authors":"Orsolya Eperjesi ,&nbsp;Maria Bucur ,&nbsp;Anett Rancz ,&nbsp;Ádám Zolcsák ,&nbsp;Marie Anne Engh ,&nbsp;Mahmoud Obeidat ,&nbsp;Andrea Szentesi ,&nbsp;Péter Hegyi ,&nbsp;Stefania Bunduc","doi":"10.1016/j.pan.2026.03.001","DOIUrl":"10.1016/j.pan.2026.03.001","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Pancreatic exocrine insufficiency (PEI) may develop after acute pancreatitis (AP). The incidence and predisposing factors are not well described, nor is optimal pancreatic enzyme replacement (PERT) in this setting. We aimed to investigate the proportion, risk factors, and effect of PERT in patients with PEI after AP.</div></div><div><h3>Methods</h3><div>The study protocol was registered on PROSPERO (CRD42024516403). We systematically searched three databases (PubMed, EMBASE, and CENTRAL) on November 08, 2025. We included studies reporting on risk factors and PERT efficacy in PEI associated with AP. Pooled proportion and odds ratios (OR) with the 95% confidence intervals (CI) were calculated using a random-effects model.</div></div><div><h3>Results</h3><div>We identified 64 eligible articles. PEI occurred in 22% (CI:17–27%) of the 24111 analyzed AP patients. The rate was high at discharge at 48% (CI: 19–79%) but decreased and stabilized at 26% (CI: 17–39%) after the 1st year of follow-up. The rates of PEI were 10% (CI: 5–20%), 24% (CI:13–40%), and 31% (CI: 18–47%) after mild, moderately severe, and severe AP, respectively. The proportion of severe PEI reached 21% (CI: 13–31%) overall, and even following mild AP, severe PEI was observed in 10% (CI:4–22%) of cases. The odds were significantly higher for alcoholic (vs. biliary) AP (OR = 1.89, CI: 1.06–3.37) cases. Necrosis did not significantly increase the risk of PEI (OR = 2.12, CI: 0.54–8.28), but necrosectomy did (OR = 3.09, CI:1.79–5.31).</div></div><div><h3>Conclusion</h3><div>PEI affects one in five AP patients in the long term. Alcoholic AP and necrosectomy are risk factors for AP-induced PEI. PEI can develop even after mild AP.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 404-411"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spink1 promotes the survival of Kras-mutant pancreatic acinar cells","authors":"Hidehiro Hayashi ,&nbsp;Shin Hamada ,&nbsp;Ryotaro Matsumoto ,&nbsp;Tetsuya Takikawa ,&nbsp;Yan Xu ,&nbsp;Ren Jie ,&nbsp;Hitomi Nakasuji ,&nbsp;Toshiaki Abe ,&nbsp;Kazuhiro Kikuta ,&nbsp;Hozumi Motohashi ,&nbsp;Masaki Ohmuraya ,&nbsp;Atsushi Masamune","doi":"10.1016/j.pan.2026.03.014","DOIUrl":"10.1016/j.pan.2026.03.014","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic cancer remains one of the most intractable malignancies due to its strong therapeutic resistance and the difficulty of early detection. Previous studies have suggested that pancreatic inflammation can promote carcinogenesis. In contrast, the regulatory mechanisms controlling trypsin activity are closely associated with susceptibility to pancreatitis. Genetic variants that lead to sustained trypsin activity—thereby promoting protease activation—have been identified in hereditary pancreatitis. Serine protease inhibitor Kazal type 1 (SPINK1) functions as an endogenous inhibitor of trypsin activity. Deletion of <em>Spink1</em> in mice causes severe pancreatic atrophy and early postnatal death. In addition to its role in pancreatitis, SPINK1 has been reported to exert cancer-promoting effects in several tumor types by supporting cell survival.</div></div><div><h3>Methods</h3><div>In the present study, we investigated whether pancreas-specific deletion of <em>Spink1</em> affects inflammation and fibrosis after caerulein-induced pancreatitis. We also investigated whether pancreas-specific deletion of <em>Spink1</em> affects <em>Kras</em>-mutant driven carcinogenesis in mice.</div></div><div><h3>Results</h3><div>Loss of <em>Spink1</em> in the pancreas induced histological changes consistent with chronic pancreatitis and was accompanied by muscle atrophy. Moreover, the combination of <em>Spink1</em> deletion and mutant <em>Kras</em> expression resulted in early lethality due to severe pancreatic atrophy. Heterozygous loss of <em>Spink1</em> also attenuated the development of pancreatic intraepithelial neoplasia (PanIN), a precancerous lesion induced by mutant <em>Kras</em>.</div></div><div><h3>Conclusions</h3><div>These findings demonstrate that SPINK1 supports the early stages of pancreatic carcinogenesis. Targeting SPINK1 may represent a novel preventive strategy to eliminate <em>Kras</em> mutant acinar cells and suppress the initiation of pancreatic cancer.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 469-478"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute pancreatitis management and outcome at tertiary hospitals in Rwanda: A prospective multicenter study","authors":"Marie Solange Mukanumviye ,&nbsp;Emile Sebera ,&nbsp;Vincent Dusabejambo ,&nbsp;Innocenti Dadamessi ,&nbsp;Dirk J. van Leeuwen ,&nbsp;Timothy B. Gardner ,&nbsp;Berhane Redae ,&nbsp;Dyna Nyampinga ,&nbsp;Eric Rutaganda ,&nbsp;Zainab Ingabire ,&nbsp;Isaie Nzayisenga ,&nbsp;Marcellin Musabende ,&nbsp;Felicien Shikama ,&nbsp;Michel Niyonsenga ,&nbsp;Gamal Salaheldin ,&nbsp;Hanna Aberra","doi":"10.1016/j.pan.2026.01.074","DOIUrl":"10.1016/j.pan.2026.01.074","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 479-481"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}